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Cancer of the Cervix - Anaesthetics
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What is Anaesthetics?Anaesthetics is a medical specialty concerned with the provision of anaesthesia, pain relief and perioperative medicine. The anaesthetist's function is to make you insensitive to pain during surgery, to supervise your recovery from anaesthesia, and to ensure you are comfortable afterwards. Many drugs and techniques may be used including general anaesthesia, regional anaesthesia, local anaesthesia and conscious sedation together with monitoring techniques appropriate to your general medical condition and the magnitude of the surgery. Your anaesthetist will stay with you at all times during and immediately after your operation and will carefully monitor the way your body responds to the stress it encounters. You may have heard the terms anaesthesia and analgesia used. To clear up any confusion, the word anaesthesia means the absence of sensation, while analgesia is the absence of pain. If only unconscious the body still reacts to pain only you don't remember it. However the myriad of consequences of pain are still there including increased incidence of infections and complications. Anaesthetics and Cancer of the Cervix.Anaesthesia may be required for diagnostic procedures such as hysteroscopy, D and C, EUA, and/or laparoscopy as well as definitive treatment including brachytherapy or hysterectomy. In addition, some procedures such as LLETZ and laser cone biopsy are occasionally performed under a local anaesthetic with or without conscious sedation. Anaesthesia for diagnostic procedures is frequently performed as a day patient with minimal discomfort to be expected afterwards. Panadeine or similar over-the-counter medication should suffice but it is wise for a pharmacist recommending such medication to be told if you have had a general anaesthetic in the past 24hrs as painkillers may make you more sleepy than expected. Anaesthesia for hysterectomy will involve a general anaesthetic. Pain relief afterwards can be provided either by an epidural or by patient controlled analgesia. Deciding which technique is best for you is quite complex and you should discuss post-operative pain relief with your Anaesthetist at the pre-operative visit. What carers need to know about Anaesthetics.Many people are frightened of an anaesthetic as it involves loss of control and entry into a dark and scary place (i.e. unconsciousness). During the preoperative visit the Anaesthetist will evaluate the patient for any medical conditions and how they might influence the anaesthetic. They will also try to allay the patient's fears by explaining what is about to happen. The patient will frequently be given a premed tablet to make them a little drowsy before they go to theatre. When the nurse arrives to give this it is best to leave the patient to gently settle into a relaxed state induced by the drugs. On arrival in the operating theatre an intravenous drip will be started using a local anaesthetic and all subsequent drugs will be given through this. When the patient wakes up they will have been given enough painkillers to make sure they are comfortable for the trip back to the ward. If the operation is major then the anaesthetist will remain in contact with the patient and supervise any advanced pain relief requirements, including patient controlled analgesia and epidural analgesia. The anaesthetist will also assist the surgical team with advice regarding monitoring in the high dependency unit, intravenous fluid and oxygen requirements. Anaesthesia has come a long way since the days of chloroform and ether but this is how many of our patients remember us. The modern anaesthetic causes very little stress to a patient's health, pain is now readily controlled and post operative nausea and vomiting are a relatively infrequent occurrence. What patients need to know about Anaesthetics.
Prior to surgery your anaesthetist will take a medical history and perform a physical examination. Based on these findings, together with the results of any investigations deemed necessary such as blood tests, ECG and/or chest X-Ray, your anaesthetist will formulate a plan of which type of anaesthetic to perform and will discuss this with you in detail. To help with this planning process your anaesthetist will need to know about:
If you are unsure of the tablets you are taking, ask your general practitioner to write a note to your anaesthetist. Bring your tablets with you to the pre-operative visit! If you feel unhappy or concerned about any aspects of your anaesthetist's plan you should talk this over as a plan can usually be safely modified to cater for individual concerns. How can you prepare for your operation?There are several simple things that can be done to improve your general condition prior to your operation:
If your operation is planned as day surgery then you will be discharged from hospital approximately 4 hours after the end of your surgery. Whilst you will be safe to travel home you must be accompanied by a responsible adult who should stay with you till the next day. You must not drive, operate machinery or sign any legal documents for 24hrs after your anaesthesia has ended. Further information
There are many sources of information about anaesthesia available on the internet. Some places to start include:
Many Anaesthetic Departments have their own web site and these may be a good source of useful information specific to your local area.
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